Essential Policies and Procedures for Senior Living
Essential Policies and Procedures for
Senior Living
Karen T. Stratoti, RN, BSN, LNHA, CALA
ESSENTIAL POLICIES AND PROCEDURES FOR SENIOR LIVING
Karen T. Stratoti, RN, BSN, LNHA, CALA
Essential Policies and Procedures for Senior Living is published by HCPro, a division of Simplify Compliance LLC. Copyright ? 2019 HCPro, a division of Simplify Compliance LLC. All rights reserved. Printed in the United States of America.
ISBN: 978-1-68308-819-6 No part of this publication may be reproduced, in any form or by any means, without prior written consent of HCPro or the Copyright Clearance Center (978-750-8400). Please notify us immediately if you have received an unauthorized copy. HCPro provides information resources for the healthcare industry. HCPro is not affiliated in any way with The Joint Commission, which owns the JCAHO and Joint Commission trademarks.
Karen T. Stratoti, RN, BSN, LNHA, CALA, Author Brianna Shipley, Senior Editor Adrienne Trivers, Product Manager Maria Tsigas, Product Director Matt Sharpe, Production Supervisor Nicole Grande, Layout/Graphic Design Zak Whittington, Cover Designer
Advice given is general. Readers should consult professional counsel for specific legal, ethical, or clinical questions.
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Contents by Category
About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii Definitions Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Activities Activities Assessment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Activities Calendar. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Activities Care Plan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Activities Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Activities Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Designation of Activities Director. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Alzheimer's/Dementia Admission Criteria for Alzheimer's/Dementia Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Alzheimer's/Dementia Program Scope and Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Alzheimer's/Dementia Staff Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Discharge Criteria for Alzheimer's/Dementia Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Missing Resident (Elopement) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Unmanageable Residents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Wandering Residents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
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Essential Policies and Procedures for Senior Living | iii
Contents by Category
Dietary Assistive Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Designation of a Food Service Coordinator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Dietary Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Dietary Department Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Employee Health and Personal Hygiene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Food Allergies and Intolerances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Menus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Preventing Foodborne Illness: Food Handling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Provision of Meals/Requirements for Dining Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Sanitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Disaster Automatic External Defibrillation (AED). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Disaster Agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Emergency Plans and Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Emergency Water Agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Physical Plant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Safety Committee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Documentation Care Planning/Interdisciplinary Committee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Charting Errors and/or Omissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Healthcare Assessment and Health Service Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 Initial Assessments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Nurses' Notes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 Order of Record Assembling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Physician's Orders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Post-Discharge Plan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
iv | Essential Policies and Procedures for Senior Living
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